Do All Men Need a PSA Test?

In 2021, more than 248,000 men learned they had prostate cancer. After skin cancer, this form is the most prevalent cancer in American men. It also comes in second as the leading cause of cancer death among men, after lung cancer. 

Fortunately, the number of deaths associated with prostate cancer decreased significantly with the advent of PSA testing. While it may not be perfect, this screening can help detect certain forms of prostate cancer in the earliest stages — reducing its chances of spreading to other parts of the body and making it easier to treat.

At Urology Associates of Southeastern North Carolina in Wilmington, North Carolina, our skilled team of urologists tailors each of our services to your individual needs. If you have a male reproductive system, here’s what you should know about PSA screenings.

How a PSA test works

This type of prostate cancer screening involves a blood test to measure a specific protein in your bloodstream, known as the prostate-specific antigen (PSA). Both noncancerous and cancerous prostate tissue produces this substance, but cancerous cells often make more, raising the amount of PSA in your bloodstream.

PSA screenings offer numerous advantages since they only require a blood test to detect prostate cancer, even in the earliest stages. This is especially beneficial because prostate cancer usually doesn’t have symptoms until it progresses. PSA testing isn’t perfect, however.

While PSA screenings can detect prostate cancer, you can also have elevated PSA numbers for other reasons, like an enlarged prostate or prostate infection — urologists refer to these PSA results as “false-positives.” 

Similarly, some forms of prostate cancer don’t produce a lot of PSA, resulting in a “false-negative.” That means you could have prostate cancer, but your PSA test result doesn’t show it.

Because of these issues, our team considers additional factors when evaluating your PSA results, such as:

• Your age and prostate size
• How quickly your PSA levels change
• Medication you may be taking

In many cases, we also combine a PSA blood test with a digital rectal exam to physically check the prostate for abnormalities.

Who should schedule a PSA test

Early detection is key when diagnosing and successfully treating prostate cancer. Therefore, experts typically recommend all people with a male reproductive system undergo regular prostate screenings from age 55-69. However, if you have a higher risk of prostate cancer, we could suggest starting your screenings earlier.

Factors that increase your chances of prostate cancer include:

• Being over age 50
• Having at least two extended family members with a history of prostate cancer
• Having a father, uncle, or brother with prostate cancer, especially if under age 65
• Inheriting gene mutations, like those associated with breast cancer (BRCA1 and BRCA2)
• Consuming a diet low in vegetables and high in animal fats

Depending on your risk factors, we could start PSA testing as early as 40 years old.

Deciphering your PSA test

While your PSA score doesn’t guarantee that you have prostate cancer, only a biopsy can definitively diagnose prostate cancer. 

If we determine that your PSA score falls within an abnormal range for your age, we usually repeat the test. If your levels remain elevated, we could order a different type of prostate cancer screening. 

Based on our findings, we can determine whether to perform a biopsy to look for abnormal cells in your prostate tissue. If we confirm the presence of prostate cancer, we can create a personalized strategy for moving forward with your diagnosis.

Are you at risk of prostate cancer? Don’t wait to schedule your PSA test. Contact our office in Wilmington, North Carolina, by calling (910) 763-6251 or request a consultation online today.